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This past Saturday, April 25th, a 7.8 earthquake struck Nepal that has led to over 4,600 deaths and 9,000 injured people (CNN, 2015). A disaster this large in size with so many people injured requires a significant international response to provide needed supplies and care. Countless buildings and homes have been destroyed, people have have lost their families and are in dire need of food, shelter, and medical care.  The United States Agency for International Development (USAID) has assisted by deploying a search and rescue team to Nepal, along with a Disaster Assistance Response Team (DART) to identify and prioritize needs (The White House, 2015). Humanitarian organizations such as Doctors Without Borders and the Red Cross have also responded to the incident to provide care to those affected by the earthquake and subsequent aftershocks (The White House, 2015).

Recent priorities since the earthquake hit have included search and rescue operations to find survivors and relief efforts (CNN, 2015). Even with the help that has arrived through international aid, however, there have been significant barriers preventing the provision of adequate medical care. Hospitals in Nepal have been overwhelmed and lack needed medical supplies, survivors remain buried in building wreckage, and rural areas are not easily accessed by rescuers (CNN, 2015). One hospital is operating at over 3 times its normal capacity with over 1,000 patients (CNN, 2015). Difficult terrain creates difficulty for surface transport to more rural villages in Nepal, while storm weather conditions preclude access via helicopters (CNN, 2015). However these villages are seeing serious damage. One village in particular saw about 70% of homes destroyed with trapped people inside, especially children and the elderly (CNN, 2015). Another cited barrier has involved the small Kathmandu airport becoming jammed with incoming aid workers, which prevents the ability of all needed aid and supplies to enter the country (CNN, 2015). The supplies highly prioritized currently are food, which approximately 1.4 million people need, and tents to withstand monsoon weather (CNN, 2015).

I believe that there are some aspects of a disaster response such as this that are difficult to control for. Earthquakes are unpredictable and as such are difficult to plan relief for as the size and magnitude cannot be know beforehand. However, in 2009 the Nepal government launched a Nepal Risk Reduction Consortium, which raised awareness of the imminence of a large disaster in addition to retrofitting hospitals to withstand an earthquake (United Nations, 2015). This act has potentially saved many lives in this earthquake as the hospitals are still standing and able to treat patients. The United Nations also plans to assist Nepal in reconstructing the country to be more resilient to disasters (United Nations, 2015). Hopefully other countries will learn from this event to strengthen their own disaster preparation.

References:

Asia News. (2012). For World Bank, Nepal is Asia’s third poorest country. Retrieved from: http://www.asianews.it/news-en/For-World-Bank,-Nepal%27s-is-Asia%27s-third-poorest-country-24668.html.

CNN. (2015). Nepal earthquake: Death toll passes 4,600 as rescuers face challenges. Retrieved from: http://www.cnn.com/2015/04/28/asia/nepal-earthquake/index.html.

The White House. (2015). America’s response to the earthquake in Nepal: What we can do to help. Retrieved from: https://www.whitehouse.gov/blog/2015/04/27/america-s-response-earthquake-nepal-what-we-can-do-help.

United Nations. (2015). UN allocated $15 million in emergency funds for Nepal earthquake response. Retrieved from: http://www.un.org/apps/news/story.asp?NewsID=50708#.VUAfI5Ozl2A.

Hurricane Katrina was the costliest natural disaster at roughly $108 billion (2005 USD) and one of the five deadliest hurricanes in the history of the United States (The Data Center, 2014). It first formed as a tropical depression on August 23^rd, 2005 but upgraded all the way to a category 5 hurricane by August 28^th, 2005. It struck the city of New Orleans with the intensity of a category 4 hurricane on August 29^th, however, despite the weakening of the storm, levee failures caused flooding of 80% of the city with some parts being under 15 feet of water (History, 2009). Because of this, there was a widespread loss of power, communication, and clean water in the city (History, 2009). In addition, there was significant damage to infrastructure such that there was only route out of the city (History, 2009).

This disaster presented huge barriers for providing and accessing healthcare. Many healthcare providers were displaced by the storm and vital public health infrastructure such as laboratories and other facilities were damaged (CDC, 2014). It was also difficult to calculate exact resource needs because many of the city’s population of 500,000 had been evacuated (CDC, 2014). Since water quality and sanitation was poor, there was a huge risk for illnesses such as cholera and norovirus (CDC, 2014). Furthermore, a majority of the people who remained in the city were those that were very poor and had no means to evacuate the city so many took refuge in the Superdome stadium, thus increasing the risk for transmission of diseases (CDC, 2014). The stadium suffered damage from human waste and trash in addition to the elements and refugees were subsequently moved to the Astrodome in Texas (CDC, 2014). There was a response from local, state and federal agencies such as FEMA, the CDC, the Coast Guard, and the Louisiana National Guard but the federal response had been criticized due to mismanagement and poor leadership.

Even though the city held its first major convention in mid-June 2006 and major events like Mardi Gras were never disrupted, the New Orleans’ recovery is still ongoing (The Data Center, (2014). As of 2013, child poverty is higher than it was before Katrina, the overall poverty rate is still the same as pre-Katrina, and 36% of the city’s renters spend over 50% of their income on housing (The Data Center, 2014).

I imagine that working as a healthcare provider during this time must have been quite difficult. Power outages, unsanitary conditions throughout the city, limited resources, and possibly even damage to hospitals could have contributed to an environment unsuitable to deliver even basic patient care. In addition, it would be hard to not only take care of people with extremely limited resources but also to effectively care for patients while worrying for the safety of your loved ones and also if there is damage to your own personal property.

I think that since this disaster, there was a lot of focus on disaster preparedness and there were many lessons learned from various responding agencies. If something were to occur in Ventura County, I know the public health department has infrastructure in place to handle disasters such as stored medical supplies, food and water. Despite this, I don’t think the average citizen has even the minimum requirements of at least a 3-day supply of water for each person in the household, 1 gallon per person per day and two weeks worth of non-perishable food, not to mention extra cash, a first aid kit, and a disaster plan (CDC, 2014).

References

CDC. (2014, December 4). Gather Emergency Supplies. Retrieved April 22, 2015, from CDC: http://www.bt.cdc.gov/preparedness/kit/disasters/

History. (2009). Hurricane Katrina. Retrieved April 27, 2015, from History: http://www.history.com/topics/hurricane-katrina

The Data Center. (2014, August 28). Facts for Features: Katrina Impact. Retrieved April 27, 2015, from The Data Center: http://www.datacenterresearch.org/data-resources/katrina/facts-for-impact/

The Times-Picayune Editorial Board. (2014, August 29). Nine years post Katrina, a recovery still in progress: Editorial. The Times-Picayune .

On March 11^th 2011 an earthquake of a magnitude of 9.0 hit the East of Japan. The earthquake did considerable damage but what followed did much more damage. A tsunami inundated about 560 sq km and resulted in a human death toll of over 19,000. Over 1 million building were destroyed or partly collapsed.

Eleven reactors at four different nuclear plants were operating at the time of the quake, all of them shut down when it hit. Subsequent inspection showed no significant damage to any of the reactors from the quake. The reactors were not affected by the quake it self but were vulnerable to the tsunami. There was power from the backup generators that were running the residual heat removal system cooling pumps at eight of the eleven units. The remaining 3 at Fukushima lost power when the site was flooded by the tsunami. The flood disabled 12 of 13 backup generators on site and also the heat exchangers for dumping reactor waste heat and decay heat into the sea. The 3 units were unable to maintain proper cooling methods and water circulation functions. The electrical switchgear was too disabled. Many weeks were spent trying to remove and restore the heat removal from the reactors. Radioactive material was released into the ocean and the air because of deliberate venting to reduce gas pressure, deliberate discharge of coolant water into the sea, and uncontrolled events. The emission into the sea is the most important individual emission of artificial radioactivity into the sea ever observed. Fukushima has some of the strongest currents causing dispersion to the Pacific Ocean.

Many inter-governmental agencies responded to the disaster; International Atomic Energy Agency, World Meteorological Organization, Comprehensive Nuclear Test Ban Treaty Organization. Most were concerned about the radiation exposure and populations around the world had lost faith in the use of nuclear power. Many countries have opted out of using nuclear power. International experts have said that workforce of thousands will take decades to clean the area.

The precise cost of the abandoned cities, towns, agricultural lands, businesses, homes and property located within 310 sq. miles have not been established. Estimates of the total economic loss range from $250-$500 billion dollars. 159, 128 people had been evacuated from the zones lost their homes and all their positions. Many of the people have not been compensated and some are still paying mortgage on homes that will never again be habitable.

There have not been any reports of people with radiation exposure because it is still early. However, when radioactive chemicals are released they are not only released in the air but in the water systems, and soil which will affect the population for years to come. Those who were closer to the incident are more likely to develop leukemia, thyroid cancer and breast cancer. There are barriers to accessing healthcare because the effects of radiation can take years to develop. It would be most beneficial to screen patients for early detection of cancers because of the exposure. This is an ongoing problem because there are the zones that are still affected by the radiation as stated above, the soil and water systems are contaminated. I could not imagine being a healthcare provider in such a huge disaster. Fukushima started as an earthquake where residents needed help with ruined homes and then for the tsunami to wreck more homes and kill more of the population and lastly constant radiation exposure in some areas. It was like 3 major disasters all within hours. I am unsure if in the future we are more prepared for a nuclear disaster. It has happened before Fukushima and I think unfortunately it is all about trial and error and having the proper policies and procedures in place.

References

Association, W. N. (2015). Fukushima Accident . Retrieved from World Nuclear Association : http://www.world-nuclear.org/info/safety-and-security/safety-of-plants/fukushima-accident/

Responsibility, P. f. (2015). Costs and Consequences of the Fukushima Disaster . Retrieved from Environmental Health Policy : http://www.psr.org/environment-and-health/environmental-health-policy-institute/responses/costs-and-consequences-of-fukushima.html